Provider Demographics
NPI:1679114409
Name:SAMSON STRENGTH & PERFORMANCE PT
Entity Type:Organization
Organization Name:SAMSON STRENGTH & PERFORMANCE PT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DELILAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BALDING
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:407-314-3465
Mailing Address - Street 1:313 COLORADO SPRINGS WAY
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092-1929
Mailing Address - Country:US
Mailing Address - Phone:407-314-3465
Mailing Address - Fax:
Practice Address - Street 1:1074 10TH AVE S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-3306
Practice Address - Country:US
Practice Address - Phone:904-242-6905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy